Time to Stop the Witch-Hunt Against Observational Studies

Sharma, Dhananjaya; Kumar, Sandeep; Agarwal, Pawan; Yadav, Sanjay Kumar

doi:10.1007/s12262-023-03714-2

Cited by 4 publications

(6 citation statements)

References 27 publications

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“…Most ASIs are products of ‘inclusive’ research by surgeons overcoming various resource constraints in LMICs, where the needs of millions (if not billions) of poor patients are financially excluded 66. ASIs provide customised, affordable and local evidence-based solutions for their patients’ health problems and deserve better than being unsung-unrecognised ideas 67…”

Section: Discussionmentioning

confidence: 99%

‘DISSEMINATE’: a roadmap for facilitating adoption of affordable surgical innovations in low and middle-income countries

et al. 2023

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ImportanceAffordable surgical innovations (ASIs) provide simple, safe and equitable solutions in resource-limited settings. Effective dissemination is needed for widespread adoption and uptake of ASIs in low and middle-income countries (LMICs). However, surgical systems in these settings face challenges with adoption and uptake of ASIs, which remain unknown and/or unused even after supporting evidence is published. A surgery-specific, implementation science-informed framework can provide a roadmap delineating the actions needed to achieve this goal; however, none exist currently. This prompted the development of a well-defined roadmap for this purpose.MethodsThe roadmap was developed after several rounds of structured brainstorming discussions among the authors, who are LMIC-based experts in academic surgery, ASIs, global health and implementation science.Results and conclusionThe proposed ‘DISSEMINATE’ roadmap presents 18 non-sequential domains to be considered in a comprehensive approach to equitable accessibility for surgical innovations:Designof the innovation;Innovateby combining the IDEAL (Idea,Development,Exploration,Assessment andLong-term follow-up) surgical innovation framework with local multidisciplinary expertise;Substantiateavailable evidence;Scale upapplication of evidence in surgical practice;Shareknowledge on multidisciplinary platforms;Sustainability;Endorsementof the innovation by local catalysts;Mediapromotion;Identifyearly adopters;Improveand refine the innovation;Improviseduring setbacks;Implementationscience methods;Navigatethrough barriers;Aspirationalaffordability;Advocacyfor the value of ASIs;Toolsfor scalability and adoption;Evaluateimpact of dissemination; andExtenduse of the innovation to resource-rich settings. This surgery-specific roadmap provides structure for effective dissemination to help in overcoming know-do gaps in the use of ASIs in LMICs.

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Section: Discussionmentioning

confidence: 99%

‘DISSEMINATE’: a roadmap for facilitating adoption of affordable surgical innovations in low and middle-income countries

et al. 2023

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“…But now we know that an RCT is not the only building block for Evidence Based Medicine. A prospective observational study with a registered research protocol, proforma-directed data collection and necessary statistical rigour is equally effective for evidence evaluation when an RCT is not feasible or necessary 8,9 .…”

Section: Evaluate the Innovation/ Idea Scientificallymentioning

confidence: 99%

Ten lessons for global surgery researchers

Sharma

2024

BJSA

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Global surgery is an area of study, research; practice and advocacy that seeks to improve health outcomes and achieve health equity for all people who require surgical care, with a special emphasis on underserved populations. Researchers and institutions in LMICs (Low and Middle Income Countries) are the major stakeholders in this and have to provide the academic leadership in this emerging field.I am a lifelong activist and campaigner for appropriate technology and affordable low-cost surgical solutions to achieve equitable surgical care for underserved populations. It gives me great pleasure to share our successful ideas which made a difference and which become our vade mecum over the years, as lessons for global surgery researchers from LMICs.

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“…Prospectively conducted observational studies have sufficient strength of evidence. [8][9][10] Evaluation of innovation There is no innovation without evaluation and every surgical innovation must conform to all five stages of the IDEAL framework. 11 Very few FSIs can confirm to all five stages; and, their very nature demands different yardsticks for their evaluation including adapted IDEAL framework: 'No Frugal Innovation without Frugal Evaluation'.…”

Section: Strength Of Evidencementioning

confidence: 99%

“…These solutions, however, face challenges at every step of the way; potential responses thereto are documented in Table 1. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]…”

mentioning

confidence: 99%

Challenges faced by frugal surgical innovations

Sharma,

Mairal,

Prabhu

et al. 2024

Trop Doct

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Time to Stop the Witch-Hunt Against Observational Studies

Cited by 4 publications

References 27 publications

‘DISSEMINATE’: a roadmap for facilitating adoption of affordable surgical innovations in low and middle-income countries

‘DISSEMINATE’: a roadmap for facilitating adoption of affordable surgical innovations in low and middle-income countries

Ten lessons for global surgery researchers

Challenges faced by frugal surgical innovations

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